Quantification of fibrinogen-to-pre-albumin ratio provides an integrating parameter for differential diagnosis and risk stratification of early-stage colorectal cancer

Table 2 The diagnostic efficacy of preoperative FPR, AFR, CEA, CA19-9, and FPR combined with CEA and CA19-9 in patients with colorectal non-neoplastic polyps, adenomas, and early-stage colorectal cancer in discovery and validation cohorts and overall population

Comparison		Biomarkers	Cut-off value	AUC	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	Youden’s index
Discovery cohort	Non-neoplastic polyps vs. adnomas	FPR	6.17	0.576	91.10	14.20	78.70	31.40	0.053
		AFR	22.69	0.549	12.90	87.10	77.78	77.65	0.027
		CEA	1.245	0.507	57.80	48.10	23.59	80.48	0.059
		CA19-9	8.165	0.528	70.40	38.80	80.60	26.63	0.095
	Adnomas vs. early-stage CRC	FPR	11.73	0.818	70.60	79.70	80.37	69.67	0.503
		AFR	14.90	0.767	76.10	66.90	66.11	76.74	0.430
		CEA	1.895	0.711	63.80	68.30	70.38	61.58	0.321
		CA19-9	16.895	0.577	41.60	73.30	64.67	51.60	0.149
		CEA+FPR	0.63	0.858	67.10	90.90	89.70	70.11	0.580
		CEA+CA19-9+FPR	0.62	0.858	67.10	90.70	89.46	70.06	0.578
	Colorectal benign polyps vs. early-stage CRC	FPR	12.47	0.792	65.10	81.30	72.25	71.62	0.464
		AFR	14.90	0.754	75.50	33.10	54.98	55.44	0.424
		CEA	1.875	0.711	63.80	69.40	65.83	67.51	0.332
		CA19-9	16.86	0.582	41.80	73.60	59.88	57.86	0.154
		CEA+FPR	0.50	0.835	68.30	83.40	79.11	74.04	0.525
		CEA+CA19-9+FPR	0.50	0.835	68.60	83.90	79.72	74.30	0.525
Validation cohort	Colorectal benign polyps vs. early-stage CRC	FPR	12.47	0.759	72.30	68.20	69.52	79.98	0.405
		AFR	14.90	0.703	70.60	65.30	67.14	68.95	0.359
		CEA	1.875	0.702	58.90	68.20	65.03	62.27	0.271
		CA19-9	16.86	0.579	43.60	73.10	61.97	56.32	0.167
		CEA+FPR	0.50	0.823	61.90	83.60	79.11	68.57	0.455
		CEA+CA19-9+FPR	0.50	0.823	61.90	83.60	79.11	68.57	0.455
Overall population	Colorectal benign polyps vs. early-stage CRC	FPR	12.47	0.780	67.20	77.80	69.08	76.27	0.450
		AFR	14.90	0.742	74.00	66.40	60.97	75.70	0.404
		CEA	1.875	0.709	62.40	68.40	59.29	71.12	0.308
		CA19-9	16.86	0.580	42.20	73.50	29.75	38.33	0.157
		CEA+FPR	0.50	0.829	63.20	86.00	76.96	76.81	0.492
		CEA+CA19-9+FPR	0.50	0.828	64.00	85.70	76.05	76.38	0.497

FPR = Fib/pAlb × 1000; AFR = Alb/Fib
CRC colorectal cancer; benign colorectal polyps include colorectal non-neoplastic and adenomatous polyps; Fib Fibrinogen; Alb albumin; pAlb pre-albumin; PPV positive predictive value; NPV negative predictive value; AUC area under curve

ISSN: 1475-2867